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Please Note: Should you experience any problems to submit this form, please print and fax it to the 
following number: +27 15 575 1582

P.O. Box 164, Alldays, 0909, South Africa, Int., Tel: +27 - 82- 307 6902  Fax: +27 -86-502 9439  
Int., Cell., +27 82 978 0025
http://www.hunters-rock.co.za  E-mail, elmarie@hunters-rock.co.za 

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